Objectives: This study describes the incidence of all fatal cases associated with Pandemic Influenza A (H1N1) in Yemen. It sets out to highlight the factors associated with poor prognosis *The authors declare that the...Objectives: This study describes the incidence of all fatal cases associated with Pandemic Influenza A (H1N1) in Yemen. It sets out to highlight the factors associated with poor prognosis *The authors declare that they have no competing interests. to enhance the implementation of prevention and control programs. Methods: The study is based on retrospective analysis of available data until 14 March 2010, as compiled by the disease control and surveillance team in Yemen. Results: Between 16 June 2009 and 14 March 2010, a total of 33 laboratory-confirmed death cases associated with pandemic influenza A (H1N1) were reported to the Diseases Control and Surveillance in the Ministry of Public Health and Population. During this period, a total of 6049 suspected influenza A (H1N1) cases were recorded. With this denominator, the case fatality rate (CFR) was 0.54%. During June through August, H1N1 confirmed cases were infrequently detected, including only 30;however, from September through December, over 200 confirmed cases were reported each month. Of the 33 cases recorded, 25 were male (76%) and 8 were female (24%), male to female ratio being 3:1. Overall median age of the death cases was 30.8 years (range 1 - 55). The most common diagnosis upon admission was pneumonia. Out of the deaths, twenty five (75.8%) had no documented underlying diseases. Chronic cardiovascular disease (9.1%) was the most commonly reported disease and 2 deaths (6.1%) were recorded as pregnant women. Conclusions: The most common diagnosis upon admission was pneumonia. Chronic cardiovascular diseases were the most commonly reported underlying conditions, while the most identified risk factor was pregnancy. These findings should be taken into consideration, when vaccination strategies are employed.展开更多
Background:The coronavirus disease 2019(COVID-19)has affected approximately 2 million individuals worldwide;however,data regarding fatal cases have been limited.Objective:To report the clinical features of 162 fatal c...Background:The coronavirus disease 2019(COVID-19)has affected approximately 2 million individuals worldwide;however,data regarding fatal cases have been limited.Objective:To report the clinical features of 162 fatal cases of COVID-19 from 5 hospitals in Wuhan between December 30,2019 and March 12,2020.Methods:The demographic data,signs and symptoms,clinical course,comorbidities,laboratory findings,computed tomographic(CT)scans,treatments,and complications of the patients with fatal cases were retrieved from electronic medical records.Results:The median patient age was 69.5(interquartile range:63.0–77.25)years,and 80%of the patients were over 61 years.A total of 112(69.1%)patients were men.Hypertension(45.1%)was the most common comorbidity,while 59(36.4%)patients had no comorbidity.At admission,131(81.9%)patients had severe or critical COVID-19,whereas 39(18.1%)patients with hypertension or chronic lung disease had moderate COVID-19.In total,126(77.8%)patients received antiviral treatment,while 132(81.5%)patients received glucocorticoid treatment.A total of 116(71.6%)patients were admitted to the intensive care unit(ICU),and 137(85.1%)patients received mechanical ventilation.Most patients received mechanical ventilation before ICU admission.Approximately 93.2%of the patients developed respiratory failure or acute respiratory distress syndrome.There were no significant differences in the inhospital survival time among the hospitals(P=0.14).Conclusion:Young patients with moderate COVID-19 without comorbidity at admission could also develop fatal outcomes.The in-hospital survival time of the fatal cases was similar among the hospitals of different levels in Wuhan.展开更多
We have proposed a new mathematical method,the SEIHCRD model,which has an excellent potential to predict the incidence of COVID-19 diseases.Our proposed SEIHCRD model is an extension of the SEIR model.Three-compartmen...We have proposed a new mathematical method,the SEIHCRD model,which has an excellent potential to predict the incidence of COVID-19 diseases.Our proposed SEIHCRD model is an extension of the SEIR model.Three-compartments have added death,hospitalized,and critical,which improves the basic understanding of disease spread and results.We have studiedCOVID-19 cases of six countries,where the impact of this disease in the highest are Brazil,India,Italy,Spain,the United Kingdom,and the United States.After estimating model parameters based on available clinical data,the modelwill propagate and forecast dynamic evolution.Themodel calculates the Basic reproduction number over time using logistic regression and the Case fatality rate based on the selected countries’age-category scenario.Themodel calculates two types of Case fatality rate one is CFR daily,and the other is total CFR.The proposed model estimates the approximate time when the disease is at its peak and the approximate time when death cases rarely occur and calculate how much hospital beds and ICU beds will be needed in the peak days of infection.The SEIHCRD model outperforms the classic ARXmodel and the ARIMA model.RMSE,MAPE,andRsquaredmatrices are used to evaluate results and are graphically represented using Taylor and Target diagrams.The result shows RMSE has improved by 56%–74%,and MAPE has a 53%–89%improvement in prediction accuracy.展开更多
To describe the case fatality rate of SARS in Beijing. Methods Data of SARS cases notified from Beijing Center for Disease Control and Prevention （BCDC） and supplemented by other channels were collected. The data we...To describe the case fatality rate of SARS in Beijing. Methods Data of SARS cases notified from Beijing Center for Disease Control and Prevention （BCDC） and supplemented by other channels were collected. The data were analyzed by rate calculation. Results The case fatality rate of SARS in Beijing was 7.66%, and had an ascending trend while the age of cases was getting older, and a descending trend while the epidemic developmem. The case fatality rate in Beijing was lower than that in other main epidemic countries or regions. Conclusions The risk of death increases with the increment of age of SARS patients. Beijing is successful in controlling and treating SARS.展开更多
<strong>Importance:</strong> Corona virus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the pandemic claiming millions of lives since the first outbr...<strong>Importance:</strong> Corona virus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the pandemic claiming millions of lives since the first outbreak was reported in Wuhan, China during December 2019. It is thus important to make cross-country comparison of the relevant rates and understand the socio-demographic risk factors. <strong>Methods: </strong>This is a record based retrospective cohort study. <strong>Table 1</strong> was extracted from <a href="https://www.worldometers.info/coronavirus/" target="_blank">https://www.worldometers.info/coronavirus/</a> and from the Corona virus resource center (<strong>Table 2</strong>, <strong>Figures 1-3</strong>), Johns Hopkins University. Data for <strong>Table 1</strong> includes all countries which reported >1000 cases and <strong>Table 2</strong> includes 20 countries reporting the largest number of deaths. The estimation of CFR, RR and PR of the infection, and disease pattern across geographical clusters in the world is presented. <strong>Results:</strong> From <strong>Table 1</strong>, we could infer that as on 4<sup>th</sup> May 2020, COVID-19 has rapidly spread world-wide with total infections of 3,566,423 and mortality of 248,291. The maximum morbidity is in USA with 1,188,122 cases and 68,598 deaths (CFR 5.77%, RR 15% and PR 16.51%), while Spain is at the second position with 247,122 cases and 25,264 deaths (CFR 13.71%, RR 38.75%, PR 9.78%). <strong>Table 2</strong> depicts the scenario as on 8<sup>th</sup> October 2020, where-in the highest number of confirmed cases occurred in US followed by India and Brazil (cases per million population: 23,080, 5007 & 23,872 respectively). For deaths per million population: US recorded 647, while India and Brazil recorded 77 and 708 respectively. <strong>Conclusion:</strong> Studying the distribution of relevant rates across different geographical clusters plays a major role for measuring the disease burden, which in-turn enables implementation of appropriate public healthcare measures.展开更多
BACKGROUND The spread of the severe acute respiratory syndrome coronavirus 2 outbreak worldwide has caused concern regarding the mortality rate caused by the infection.The determinants of mortality on a global scale c...BACKGROUND The spread of the severe acute respiratory syndrome coronavirus 2 outbreak worldwide has caused concern regarding the mortality rate caused by the infection.The determinants of mortality on a global scale cannot be fully understood due to lack of information.AIM To identify key factors that may explain the variability in case lethality across countries.METHODS We identified 21 Potential risk factors for coronavirus disease 2019(COVID-19)case fatality rate for all the countries with available data.We examined univariate relationships of each variable with case fatality rate(CFR),and all independent variables to identify candidate variables for our final multiple model.Multiple regression analysis technique was used to assess the strength of relationship.RESULTS The mean of COVID-19 mortality was 1.52±1.72%.There was a statistically significant inverse correlation between health expenditure,and number of computed tomography scanners per 1 million with CFR,and significant direct correlation was found between literacy,and air pollution with CFR.This final model can predict approximately 97%of the changes in CFR.CONCLUSION The current study recommends some new predictors explaining affect mortality rate.Thus,it could help decision-makers develop health policies to fight COVID-19.展开更多
BACKGROUND Crizotinib-induce hepatotoxicity is rare and non-specific, and severe hepatotoxicity can develop into fatal liver failure. Herein, we report a case of fatal crizotinib-induced liver failure in a 37-year-old...BACKGROUND Crizotinib-induce hepatotoxicity is rare and non-specific, and severe hepatotoxicity can develop into fatal liver failure. Herein, we report a case of fatal crizotinib-induced liver failure in a 37-year-old Asian patient.CASE SUMMARY The patient complained of dyspnea and upper abdominal pain for a week in August 2017. He was diagnosed with anaplastic lymphoma kinase-rearranged lung adenocarcinoma combined with multiple distant metastases. Crizotinib was initiated as a first-line treatment at a dosage of 250 mg twice daily. No adverse effects were seen until day 46. On day 55, he was admitted to the hospital with elevated liver enzymes aspartate aminotransferase(AST)(402 IU/L), alanine aminotransferase(ALT)(215 IU/L) and total bilirubin(145 μmol/L) and was diagnosed with crizotinib-induced fulminant liver failure. Despite crizotinib discontinuation and intensive supportive therapy, the level of AST(1075 IU/L),ALT(240 IU/L) and total bilirubin(233 μmol/L) continued to rapidly increase,and he died on day 60.CONCLUSION Physicians should be aware of the potential fatal adverse effects of crizotinib.展开更多
We compared subgroup differences in COVID-19 case and mortality and investigated factors associated with case and mortality rate(MR)measured at the county level in Mississippi.Findings were based on data published by ...We compared subgroup differences in COVID-19 case and mortality and investigated factors associated with case and mortality rate(MR)measured at the county level in Mississippi.Findings were based on data published by the Mississippi State Department of Health between March 11 and July 16,2020.The COVID-19 case rate and case fatality rate(CFR)differed by gender and race,while MR only differed by race.Residents aged 80 years or older and those who live in a non-metro area had a higher case rate,CFR,and MR.After controlling for selected factors,researchers found that the percent of residents who are obese,low income,or with certain chronic conditions were associated with the county COVID-19 case rate,CFR,and/or MR,though some were negatively related.The findings may help the state to identify counties with higher COVID-19 case rate,CFR,and MR based on county demographics and the degree of its chronic conditions.展开更多
BACKGROUND Tuberculosis (TB) is a rare etiology of the septic shock. Timely administration of the anti-microbial agents has shown mortality benefit. Prompt diagnosis and a high index of suspicion are crucial to the ma...BACKGROUND Tuberculosis (TB) is a rare etiology of the septic shock. Timely administration of the anti-microbial agents has shown mortality benefit. Prompt diagnosis and a high index of suspicion are crucial to the management. We present three cases of TBSS with poor outcome in the majority despite timely and susceptible antibiotic administration. CASE SUMMARY Sixty-seven-year-old woman with latent TB presented with fever, cough, and shortness of breath. She was promptly diagnosed with active TB and started on the appropriate anti-microbial regimen;she had a worsening clinical course with septic shock and multi-organ failure after initiation of antibiotics. Thirty-threeyear- old man immunocompromised with acquired immune deficiency syndrome presented with fever, anorexia and weight loss. He had no respiratory symptoms, and first chest X-ray was normal. He had enlarged liver, spleen and lymph nodes suspicious for lymphoma. Despite broad-spectrum antibiotics, he succumbed to refractory septic shock and multi-organ failure. It was shortly before his death that anti-TB antimicrobials were initiated based on pathology reports of bone marrow and lymph node biopsies. Forty-nine-year-old woman with asthma and latent TB admitted with cough and shortness of breath. Although Initial sputum analysis was negative, a subsequent broncho-alveolar lavage turned out to be positive for acid fast bacilli followed by initiation of susceptible ant-TB regimen. She had a downward spiral clinical course with shock, multi-organ failure and finally death. CONCLUSION Worse outcome despite timely initiation of appropriate antibiotics raises suspicion of TB immune reconstitution as a possible pathogenesis for TB septic shock.展开更多
Marburg virus disease(MVD)is a highly fatal illness,with a case fatality rate of up to 88%,though this rate can be significantly reduced with prompt and effective patient care.The disease was first identified in 1967 ...Marburg virus disease(MVD)is a highly fatal illness,with a case fatality rate of up to 88%,though this rate can be significantly reduced with prompt and effective patient care.The disease was first identified in 1967 during concurrent outbreaks in Marburg and Frankfurt,Germany,and in Belgrade,Serbia,linked to laboratory use of African green monkeys imported from Uganda.Subsequent outbreaks and isolated cases have been reported in various African countries,including Angola,the Democratic Republic of the Congo,Equatorial Guinea,Ghana,Guinea,Kenya,Rwanda,South Africa(in an individual with recent travel to Zimbabwe),Tanzania,and Uganda.Initial human MVD infections typically occur due to prolonged exposure to mines or caves inhabited by Rousettus aegyptiacus fruit bats,the natural hosts of the virus.展开更多
文摘Objectives: This study describes the incidence of all fatal cases associated with Pandemic Influenza A (H1N1) in Yemen. It sets out to highlight the factors associated with poor prognosis *The authors declare that they have no competing interests. to enhance the implementation of prevention and control programs. Methods: The study is based on retrospective analysis of available data until 14 March 2010, as compiled by the disease control and surveillance team in Yemen. Results: Between 16 June 2009 and 14 March 2010, a total of 33 laboratory-confirmed death cases associated with pandemic influenza A (H1N1) were reported to the Diseases Control and Surveillance in the Ministry of Public Health and Population. During this period, a total of 6049 suspected influenza A (H1N1) cases were recorded. With this denominator, the case fatality rate (CFR) was 0.54%. During June through August, H1N1 confirmed cases were infrequently detected, including only 30;however, from September through December, over 200 confirmed cases were reported each month. Of the 33 cases recorded, 25 were male (76%) and 8 were female (24%), male to female ratio being 3:1. Overall median age of the death cases was 30.8 years (range 1 - 55). The most common diagnosis upon admission was pneumonia. Out of the deaths, twenty five (75.8%) had no documented underlying diseases. Chronic cardiovascular disease (9.1%) was the most commonly reported disease and 2 deaths (6.1%) were recorded as pregnant women. Conclusions: The most common diagnosis upon admission was pneumonia. Chronic cardiovascular diseases were the most commonly reported underlying conditions, while the most identified risk factor was pregnancy. These findings should be taken into consideration, when vaccination strategies are employed.
基金supported by the National Natural Science Foundation of China(81900097,81903401)the Emergency Response Project of Hubei Science and Technology Department(2020FCA023)+3 种基金the Young Taishan Scholars Program of Shandong Province of China(tsqn20161046)the Shandong Province Higher Educational Young and Innovation Technology Supporting Program(2019KJL004)the Academic Promotion Program of Shandong First Medical University(2019RC010)the Emergency Diagnostic and Therapeutic Center of Central China.
文摘Background:The coronavirus disease 2019(COVID-19)has affected approximately 2 million individuals worldwide;however,data regarding fatal cases have been limited.Objective:To report the clinical features of 162 fatal cases of COVID-19 from 5 hospitals in Wuhan between December 30,2019 and March 12,2020.Methods:The demographic data,signs and symptoms,clinical course,comorbidities,laboratory findings,computed tomographic(CT)scans,treatments,and complications of the patients with fatal cases were retrieved from electronic medical records.Results:The median patient age was 69.5(interquartile range:63.0–77.25)years,and 80%of the patients were over 61 years.A total of 112(69.1%)patients were men.Hypertension(45.1%)was the most common comorbidity,while 59(36.4%)patients had no comorbidity.At admission,131(81.9%)patients had severe or critical COVID-19,whereas 39(18.1%)patients with hypertension or chronic lung disease had moderate COVID-19.In total,126(77.8%)patients received antiviral treatment,while 132(81.5%)patients received glucocorticoid treatment.A total of 116(71.6%)patients were admitted to the intensive care unit(ICU),and 137(85.1%)patients received mechanical ventilation.Most patients received mechanical ventilation before ICU admission.Approximately 93.2%of the patients developed respiratory failure or acute respiratory distress syndrome.There were no significant differences in the inhospital survival time among the hospitals(P=0.14).Conclusion:Young patients with moderate COVID-19 without comorbidity at admission could also develop fatal outcomes.The in-hospital survival time of the fatal cases was similar among the hospitals of different levels in Wuhan.
基金The work has been supported by a grant received from the Ministry of Education,Government of India under the Scheme for the Promotion of Academic and Research Collaboration(SPARC)(ID:SPARC/2019/1396).
文摘We have proposed a new mathematical method,the SEIHCRD model,which has an excellent potential to predict the incidence of COVID-19 diseases.Our proposed SEIHCRD model is an extension of the SEIR model.Three-compartments have added death,hospitalized,and critical,which improves the basic understanding of disease spread and results.We have studiedCOVID-19 cases of six countries,where the impact of this disease in the highest are Brazil,India,Italy,Spain,the United Kingdom,and the United States.After estimating model parameters based on available clinical data,the modelwill propagate and forecast dynamic evolution.Themodel calculates the Basic reproduction number over time using logistic regression and the Case fatality rate based on the selected countries’age-category scenario.Themodel calculates two types of Case fatality rate one is CFR daily,and the other is total CFR.The proposed model estimates the approximate time when the disease is at its peak and the approximate time when death cases rarely occur and calculate how much hospital beds and ICU beds will be needed in the peak days of infection.The SEIHCRD model outperforms the classic ARXmodel and the ARIMA model.RMSE,MAPE,andRsquaredmatrices are used to evaluate results and are graphically represented using Taylor and Target diagrams.The result shows RMSE has improved by 56%–74%,and MAPE has a 53%–89%improvement in prediction accuracy.
文摘To describe the case fatality rate of SARS in Beijing. Methods Data of SARS cases notified from Beijing Center for Disease Control and Prevention （BCDC） and supplemented by other channels were collected. The data were analyzed by rate calculation. Results The case fatality rate of SARS in Beijing was 7.66%, and had an ascending trend while the age of cases was getting older, and a descending trend while the epidemic developmem. The case fatality rate in Beijing was lower than that in other main epidemic countries or regions. Conclusions The risk of death increases with the increment of age of SARS patients. Beijing is successful in controlling and treating SARS.
文摘<strong>Importance:</strong> Corona virus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the pandemic claiming millions of lives since the first outbreak was reported in Wuhan, China during December 2019. It is thus important to make cross-country comparison of the relevant rates and understand the socio-demographic risk factors. <strong>Methods: </strong>This is a record based retrospective cohort study. <strong>Table 1</strong> was extracted from <a href="https://www.worldometers.info/coronavirus/" target="_blank">https://www.worldometers.info/coronavirus/</a> and from the Corona virus resource center (<strong>Table 2</strong>, <strong>Figures 1-3</strong>), Johns Hopkins University. Data for <strong>Table 1</strong> includes all countries which reported >1000 cases and <strong>Table 2</strong> includes 20 countries reporting the largest number of deaths. The estimation of CFR, RR and PR of the infection, and disease pattern across geographical clusters in the world is presented. <strong>Results:</strong> From <strong>Table 1</strong>, we could infer that as on 4<sup>th</sup> May 2020, COVID-19 has rapidly spread world-wide with total infections of 3,566,423 and mortality of 248,291. The maximum morbidity is in USA with 1,188,122 cases and 68,598 deaths (CFR 5.77%, RR 15% and PR 16.51%), while Spain is at the second position with 247,122 cases and 25,264 deaths (CFR 13.71%, RR 38.75%, PR 9.78%). <strong>Table 2</strong> depicts the scenario as on 8<sup>th</sup> October 2020, where-in the highest number of confirmed cases occurred in US followed by India and Brazil (cases per million population: 23,080, 5007 & 23,872 respectively). For deaths per million population: US recorded 647, while India and Brazil recorded 77 and 708 respectively. <strong>Conclusion:</strong> Studying the distribution of relevant rates across different geographical clusters plays a major role for measuring the disease burden, which in-turn enables implementation of appropriate public healthcare measures.
文摘BACKGROUND The spread of the severe acute respiratory syndrome coronavirus 2 outbreak worldwide has caused concern regarding the mortality rate caused by the infection.The determinants of mortality on a global scale cannot be fully understood due to lack of information.AIM To identify key factors that may explain the variability in case lethality across countries.METHODS We identified 21 Potential risk factors for coronavirus disease 2019(COVID-19)case fatality rate for all the countries with available data.We examined univariate relationships of each variable with case fatality rate(CFR),and all independent variables to identify candidate variables for our final multiple model.Multiple regression analysis technique was used to assess the strength of relationship.RESULTS The mean of COVID-19 mortality was 1.52±1.72%.There was a statistically significant inverse correlation between health expenditure,and number of computed tomography scanners per 1 million with CFR,and significant direct correlation was found between literacy,and air pollution with CFR.This final model can predict approximately 97%of the changes in CFR.CONCLUSION The current study recommends some new predictors explaining affect mortality rate.Thus,it could help decision-makers develop health policies to fight COVID-19.
文摘BACKGROUND Crizotinib-induce hepatotoxicity is rare and non-specific, and severe hepatotoxicity can develop into fatal liver failure. Herein, we report a case of fatal crizotinib-induced liver failure in a 37-year-old Asian patient.CASE SUMMARY The patient complained of dyspnea and upper abdominal pain for a week in August 2017. He was diagnosed with anaplastic lymphoma kinase-rearranged lung adenocarcinoma combined with multiple distant metastases. Crizotinib was initiated as a first-line treatment at a dosage of 250 mg twice daily. No adverse effects were seen until day 46. On day 55, he was admitted to the hospital with elevated liver enzymes aspartate aminotransferase(AST)(402 IU/L), alanine aminotransferase(ALT)(215 IU/L) and total bilirubin(145 μmol/L) and was diagnosed with crizotinib-induced fulminant liver failure. Despite crizotinib discontinuation and intensive supportive therapy, the level of AST(1075 IU/L),ALT(240 IU/L) and total bilirubin(233 μmol/L) continued to rapidly increase,and he died on day 60.CONCLUSION Physicians should be aware of the potential fatal adverse effects of crizotinib.
文摘We compared subgroup differences in COVID-19 case and mortality and investigated factors associated with case and mortality rate(MR)measured at the county level in Mississippi.Findings were based on data published by the Mississippi State Department of Health between March 11 and July 16,2020.The COVID-19 case rate and case fatality rate(CFR)differed by gender and race,while MR only differed by race.Residents aged 80 years or older and those who live in a non-metro area had a higher case rate,CFR,and MR.After controlling for selected factors,researchers found that the percent of residents who are obese,low income,or with certain chronic conditions were associated with the county COVID-19 case rate,CFR,and/or MR,though some were negatively related.The findings may help the state to identify counties with higher COVID-19 case rate,CFR,and MR based on county demographics and the degree of its chronic conditions.
文摘BACKGROUND Tuberculosis (TB) is a rare etiology of the septic shock. Timely administration of the anti-microbial agents has shown mortality benefit. Prompt diagnosis and a high index of suspicion are crucial to the management. We present three cases of TBSS with poor outcome in the majority despite timely and susceptible antibiotic administration. CASE SUMMARY Sixty-seven-year-old woman with latent TB presented with fever, cough, and shortness of breath. She was promptly diagnosed with active TB and started on the appropriate anti-microbial regimen;she had a worsening clinical course with septic shock and multi-organ failure after initiation of antibiotics. Thirty-threeyear- old man immunocompromised with acquired immune deficiency syndrome presented with fever, anorexia and weight loss. He had no respiratory symptoms, and first chest X-ray was normal. He had enlarged liver, spleen and lymph nodes suspicious for lymphoma. Despite broad-spectrum antibiotics, he succumbed to refractory septic shock and multi-organ failure. It was shortly before his death that anti-TB antimicrobials were initiated based on pathology reports of bone marrow and lymph node biopsies. Forty-nine-year-old woman with asthma and latent TB admitted with cough and shortness of breath. Although Initial sputum analysis was negative, a subsequent broncho-alveolar lavage turned out to be positive for acid fast bacilli followed by initiation of susceptible ant-TB regimen. She had a downward spiral clinical course with shock, multi-organ failure and finally death. CONCLUSION Worse outcome despite timely initiation of appropriate antibiotics raises suspicion of TB immune reconstitution as a possible pathogenesis for TB septic shock.
文摘Marburg virus disease(MVD)is a highly fatal illness,with a case fatality rate of up to 88%,though this rate can be significantly reduced with prompt and effective patient care.The disease was first identified in 1967 during concurrent outbreaks in Marburg and Frankfurt,Germany,and in Belgrade,Serbia,linked to laboratory use of African green monkeys imported from Uganda.Subsequent outbreaks and isolated cases have been reported in various African countries,including Angola,the Democratic Republic of the Congo,Equatorial Guinea,Ghana,Guinea,Kenya,Rwanda,South Africa(in an individual with recent travel to Zimbabwe),Tanzania,and Uganda.Initial human MVD infections typically occur due to prolonged exposure to mines or caves inhabited by Rousettus aegyptiacus fruit bats,the natural hosts of the virus.
